CMS Formulary

Displaying 169541-169550 of 1611142 results.
ID: 169541
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 245220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169542
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169543
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169544
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169545
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169546
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 207273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169547
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169548
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169549
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169550
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30